The Itch: Allergies, Asthma, Eczema & Immunology

#137 - Diagnosing Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)


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Persistent congestion, pressure, or a reduced sense of smell often gets mistaken for allergies or a stubborn cold when it may be something more, like chronic rhinosinusitis with nasal polyps (CRSwNP). Getting the right diagnosis is the first step toward real relief.

Dr. Tonya Farmer, a board-certified ENT, joins Kortney and Dr. G to explain how chronic rhinosinusitis with nasal polyps (CRSwNP) is diagnosed. She walks us through the full evaluation: what symptoms matter, what a nasal endoscopy actually shows, when a CT scan is needed, and how type 2 inflammation fits into the picture.

What we cover about diagnosing CRSwNP:
  • Key symptoms: Persistent congestion, drainage, facial pressure, and especially loss of smell are major red flags for CRSwNP.
  • Why duration matters: Chronic means 12 weeks or longer. If symptoms keep coming back or never truly improve, it’s time to look deeper.
  • The physical exam: ENTs use nasal endoscopy to see swelling, mucus, or polyps that aren’t visible from the outside.
  • When CT scans are needed: Imaging helps confirm sinus inflammation and shows the extent of polyp growth.
  • Additional testing: Allergy testing, IgE levels, eosinophils, and other immune markers help identify type 2 inflammation and guide next steps.
  • When to see a specialist: If antibiotics, steroids, or over-the-counter treatments aren’t helping, ask for a referral to an allergist or ENT. Early diagnosis can prevent worsening symptoms and reduce the need for surgery.
  • Set the foundations: Ep. 133: What is Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)?

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    Made in partnership with The Allergy & Asthma Network.

    Thanks to Sanofi for sponsoring today’s episode. 

    This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

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